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Welfare Reform on the Web (March 2002): National Health Service - Community and Primary Care Services

CALLED TO ACCOUNT

Health Service Journal, vol. 112, Jan. 17th 2002, p. 22-23

Primary Care Trusts are set to control 75% of the NHS budget. Many will be hampered in their new roles by inexperienced managers, unproven processes and fledgling support systems. Workforce planning and the appointment of dedicated project managers to drive change is an urgent priority.

GP SHORTAGE TO WORSEN AS YOUNG DOCTORS SWITCH TO PART-TIME WORK

J. Carvel

The Guardian, Dec. 28th 2001, p. 2

The British Medical Association has warned of the dangers of a shift to part-time working by GPs that threatens the government's forecasts of the number of family doctors needed to meet the expanding workload of primary care. The figures came from an age analysis of a survey of 23,521 GPs in October.

MANAGEMENT IN PRIMARY CARE GROUPS AND TRUSTS

B. Dowling, D. Wilkin and A. Coleman

British Journal of Health Care Management, vol. 8, 2002, p. 12-15

Primary Care Groups and Trusts (PCG/Ts) are central to the British government's plans to modernise the NHS. To fulfil their functions they will require sufficient numbers of skilled managers supported by an adequately resourced staffing infrastructure. Paper reviews the management capacity of PCG/Ts two years after their inception. Concludes that current limitations on management capacity in PCG/Ts, combined with high expectations of their role in modernising the NHS, pose a real risk that they will be unable to deliver all of the required changes and meet the targets set out in the NHS Plan.

THE OBJECT OF THE EXERCISE

D. Florin et al

Health Service Journal, vol. 112, Jan. 17th 2002, p. 26-27

A study of six primary care trusts showed that the most successful in tackling health improvement had certain common characteristics. Strong board-level support and leadership, combined with development funding were the most effective. Successful PCTs also showed a corporate recognition of local health and socio-economic inequalities.

ORGANIZATION AND FINANCING OF BRITISH PRIMARY CARE GROUPS AND TRUSTS: OBSERVATIONS THROUGH THE PRISM OF US MANAGED CARE

J. Weiner, S. Gillam and R. Lewis

Journal of Health Services Research and Policy, vol. 7, 2002, p. 43-50

Argues that people developing primary care groups and trusts (PCG/Ts) can learn from the American experience with health maintenance organisations. Following an overview of US managed care and an update on the progress of UK PCGs and PCTs, article suggests how consortia of PCGs and PCTs might be developed and how budgets and provider incentives might be structured. This international comparison suggests that the resources needed to support the development of effective PCGs and PCTs will be considerable, as will the need to maintain organizational flexibility. It will also be essential to develop integrated budgets for primary and secondary care.

PCTs WILL NOT BE ABLE TO FULFIL THEIR NEW ROLE

J. Shapiro

Primary Care Report, vol. 3, Dec. 2001, p. 14-15

Argues that emerging Primary Care Trusts will be unable to fulfil the role envisaged for them by government and that we need to slow the pace of change, The PCTs are now too large to address local population health needs, lack the necessary management expertise to take on most of the tasks of Health Authorities as planned and lack time to develop and train up staff to cope.

PFI HAS SOME BENEFITS FOR PCTs, BUT BE CAUTIOUS

M. Pownell

Primary Care Report, vol. 3, Dec. 2001, p. 6-9

Discusses the advantages and disadvantages of public-private partnerships for primary care organisations. Warns that NHS income could be diverted from patient care to meet private sector profit targets if retail and commercial parts of a development do not take off as planned.

SALARIED CONTRACTS IN UK GENERAL PRACTICE: A STUDY OF JOB SATISFACTION AND STRESS

T. Gosden et al

Journal of Health Services Research and Policy, vol. 7, 2002, p. 26-33

Job satisfaction and stress levels were assessed using data from two postal surveys of GPs: a national survey of GPs on a standard performance-related contract carried out in 1998; and a survey of salaried GPs and their non-salaried GP employers in 1999. Results showed that salaried contracts were associated with lower stress levels, and higher satisfaction with some job characteristics such as income and hours of work. However, overall satisfaction levels were no higher than those of non-salaried GPs in both the Personal Medical Services pilots and on the standard GP contract.

USE PATIENT FEEDBACK TO IMPLEMENT THE NHS PLAN

M. Greco

Primary Care Report, vol. 3, Dec. 2001, p. 24-26

The government believes that the NHS can learn from patients, carers and the public and wishes to ensure their systematic involvement. A number of primary care organisations are promoting patient involvement by implementing surveys using an instrument called the Improving Practice Questionnaire.

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